This study proposes the examination of inequalities in access to health care by evaluating the surgical outcomes at high- and low-volume hospitals and the patient populations that receive care at each hospital type. It has been established that mortality is significantly decreased for complex surgical procedures performed at high volume hospitals. What remains unknown is whether high volume hospitals are equally accessible to patients of different race, socioeconomic status and insurance coverage. This study will create a data-set of complex surgical care procedures (pancreatectomy for pancreatic cancer, esophageal resection for esophageal cancer, colectomy for colon cancer and lung resection for lung cancer) done at both high and low volume hospitals and examine the characteristics of the patient population that receives care at each type of hospital.